Association of depression and sleep quality with frailty: a cross-sectional study in China.

Background: With the rapid growth of global aging, frailty has become a serious public health burden, affecting the life quality of older adults. Depressive symptoms (depression hereafter) and sleep quality are associated with frailty, but the pathways in which sleep quality and depression affect frailty remain unclear. Method: This cross-sectional study included 1866 community-dwelling older adults. Demographic characteristics and health-related data of them was collected, and we also assessed frailty, depression, and sleep quality. Descriptive statistics were carried out and ordinal logistic regression analysis was used to identify the factors correlated with frailty. Spearman correlation analysis and mediation analysis were employed to assess associations between sleep quality, depression and frailty. Two-sided p < 0.05 was considered as significant. Results: The results showed that 4.1% older adults were frail and 31.0% were pre-frail. Ordinal logistic regression showed that age, consumptions of vegetables, exercise, sleep quality, depression, number of chronic diseases, chronic pain, and self-rated health were correlated with frailty. Spearman correlation analysis revealed that frailty was associated with depression and sleep quality. There was a mediation effect that sleep quality was a significant and positive predictor of frailty (total effect = 0.0545, 95% boot CI = 0.0449-0.0641), and depression was a mediator between sleep quality and frailty (mediation effect = 60.4%). Conclusion: Depression and poor sleep quality may be early indicators of frailty in older adults. Improving the sleep quality and psychological state of older adults can improve frailty, which is beneficial for healthy aging.

[Quality assessment on the case reports in Chinese Acupuncture and Moxibustion based on the guideline for the case report of TCM in China].

OBJECTIVE: To carry on the quality assessment of the case reports published in Chinese Acupuncture and Moxibustion. METHODS: The case reports were retrieved electronically published in Chinese Acupuncture and Moxibustion from 2006 to 2016. The Writing guideline for case report of traditional Chinese medicine was adopted to assess the quality of case report, in which, 15 items were included. The percentage of each item was calculated as the quality score. RESULTS: Totally, 288 case reports were included. The reports on the title, patient's information, clinical manifestations and treatment measures were quite complete (accounting to over 90%). But the report was limited on the key words, abstract, background and the informed consent. The overall quality score was low (accounting to 88.19%). Of 288 case reports, only 34 case reports (accounting to 11.81%) were of the high quality. The overall quality score of the inclusive literatures was in the range from 29 to 31 points. CONCLUSION: It is necessary to improve the quality of case report on acupuncture and moxibustion. It is anticipated to develop the writing guideline for the case report on acupuncture and moxibustion for the contribution to the development of acupuncture and moxibustion.